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How to Unlearn Your Pain

by Dr Howard Schubiner(more info)

listed in mind body, originally published in issue 179 - February 2011

There are literally millions of people currently suffering with chronic pain. My work with people with chronic pain has shown me what a devastating impact pain can have on one's life. Every day, someone tells me that pain has "ruined their life", or that they have become a "professional pain patient".


Since I started the Unlearn Your Pain program in 2003, I have learned a great deal about pain and am thrilled to report that we have seen amazing results in the majority of people who enter this program. In fact, a recent follow up study showed that people who entered the 4-week program at Providence Hospital in Southfield, MI had the following results. 67% had at least a 30% reduction in pain at a 6 month follow up evaluation, and 54% had at least a 50% reduction in pain. These are remarkable results, given that the average duration of pain was about 9 years!

There are several steps to Unlearning Your Pain and the complete program for healing can be found in my book Unlearn Your Pain. In this article, I will offer a synopsis of the steps that I have found helpful in reversing chronic pain.

Book Cover Unlearn Your Pain

First, it is critical to understand what is causing the pain. This might seem easy, but often it is more difficult than one might imagine. Those with chronic pain that is caused by cancer often require strong pain medications. I do not work with pain caused by cancer, fractures, or infections/inflammation. However, the majority of people with chronic pain have pain that is diagnosed as fibromyalgia, migraine or tension headaches, or irritable bowel syndrome. The pain in those disorders is just as real as the pain caused by cancer, fractures or infections. However, that pain is not caused by a structural disease process in the body. It is caused by learned nerve pathways. Learned nerve pathways are simply connections between the brain and body that produce actions in the body. If you learned to ride a bicycle as a child, that develops a learned nerve pathway. That pathway will always exist and you'll be able to ride a bike later in life. Signing a name, eating, walking, and reacting to every day events are all caused by learned nerve pathways. Cutting edge neuroscience has shown that pain pathways can be learned and can persist for year in the absence of a disease process in the body. This is the cause of most chronic pain, including most back and neck pain. (Please see my website or my book for a detailed description of how back and neck pains are typically caused by these pathways.)

Once you have determined that your pain is caused by learned nerve pathways (this is also known as Tension Myositis Syndrome, a term coined by Dr John Sarno in The Mindbody Prescription, or Mind Body Syndrome, as described in Unlearn Your Pain), the next step is to figure out what has led to the development of these pain pathways. There is a detailed process for doing this in Unlearn Your Pain. Briefly, a careful review of life events is usually sufficient to find connections between stressful life events and the onset of these pain syndromes. Here are a couple of examples that illustrate how stressful life events can trigger severe and chronic pain.

A 45 year old woman was abused both physically and sexually for much of her childhood. She developed anxiety in childhood which was manifest by fear of being alone and the need to connect as much as possible to the people in her life, including her abusers. This is a common reaction to abuse; other common reaction being fear and inability to connect to anyone and the inability to feel emotions. She also blamed herself for the abuse and develop the belief that she was unworthy of love and self-esteem. As she grew up, she experienced other events which caused fear and anxiety, such as the loss of a boyfriend (who spread false rumours about her), the death of a parent, a divorce after her husband 'cheated' on her and the loss of a job (after being harassed by a boss). Each of these stressors in later life caused the onset of a new symptom. Initially irritable bowel syndrome, then severe headaches, then TMJ pain, then pelvic pain, and finally widespread pain, diagnosed as fibromyalgia.

A 47 year old woman presented with head pain for 17 years. She had seen over 20 physicians, including several headache clinics and had even had facial surgery to try to alleviate the pain. She had also been on over 20 different medications without relief. Her mother was described as "being in her own world" and her father was described as being "bipolar". When her father was in a bad mood, he would grab her by her collar and scream at her: "You idiot; you jerk; what's wrong with you?; can't you do anything right?" These events recurred on a regular basis during her childhood. She developed no symptoms until she was 30 years old. One day, she obtained a new pair of glasses and immediately upon putting them on, she developed pain on the left side of her head which lasted for 17 years. When asked about the stressors in her life when she got her new glasses, she realized that she has just gotten a new boss, who was a "mean and nasty woman" who used to yell and scream at her.

The third step in the process of healing is to recognize that the pain is caused by learned nerve pathways, that there is no serious physical or structural problem in your body, and that you can actually get better! This is a powerful and important step that activates healing and serves to reduce pain.

Finally, I suggest a process to reverse the pain. In the program I've developed, it consists of a 4-week course of exercises designed to better understand and cope with stress and emotional distress. The program is contained in Unlearn Your Pain and consists of therapeutic writing exercises, meditative exercises, sets of affirmations, and learning to make necessary changes to promote contentment and well-being.

Here are some of the writing exercises that I recommend.
  • Free-writing exercises on a topic that has been troubling (either from the past or present): write quickly and freely without concern for grammar or punctuation; express your feelings fully; writing several days in a row on a specific topic usually helps us get our deepest feelings out and understand why we are bothered and what we can do about the situation;
  • Writing unsent letters. These letters can be to anyone from your past or present, or even to institutions or aspects of yourself. These work in a similar fashion to the free-writing exercises.
I also recommend mindfulness meditation as a powerful method of seeing the truth about issues in one's life and coping with them. I have taught mindfulness for over a decade and find it to be a simple, yet remarkable tool that can be used on a daily basis by anyone.

Affirmations or self-talk is another way to reverse pain because it allows the conscious parts of the brain to retrain and override the subconscious parts of the brain. It is these subconscious or automatic parts of the brain that create and perpetuate chronic pain pathways.

It is truly amazing to see people take on the challenge of changing their lives in order to reverse their pain. Some people get better quite quickly as they learn to let go of anger, guilt, or fear from prior stressful events. Others need to make significant changes in their lives in order to free themselves from stressful situations that are ongoing. Some people gradually work on taking control and stopping their pain over time. The key to resolving chronic pain is understanding what is causing it. If you suffer from chronic pain and haven't been helped by the traditional medical or alternative health methods, you might be suffering from a condition (learned nerve pathways) that can be reversed. And it might not be that difficult to accomplish.

Holly's Story

Holly's story is an example of the remarkable recoveries that can occur within a relatively short time after learning that real pain can be caused by learned nerve pathways, which Holly refers to as MBS (Mind Body Syndrome).

The spring that I was 16, I was a sophomore in high school and things were going well. I was a straight A student, ranked second in my class. I had started a new job at a produce market. My mom and I had just gotten two new puppies that we were training together. In the past year I had developed some knee problems, which made it hard to train our little dogs and uncomfortable for me to walk or bend at times, but I did my exercises and made the best of things.

Everything changed in May that year. Over the course of one week I was struck first with severe lower leg pain, then arm pain, both right and left. I could barely walk and was hospitalized overnight for tests, including an MRI and a spinal tap. The tests were inconclusive so I was started on medication and sent home. I also developed other symptoms: rapid heartbeat, dizziness, hot and cold flashes, cold feet, tingling in my hands, headaches, difficulty concentrating and severe fatigue. My neurologist did not know what was wrong with me, so two months later my parents and I drove 12 hours for me to be seen at the Mayo Clinic. Over five days the doctor did many more tests, but they were completely unable to make a diagnosis.

I saw a number of other doctors over the next two years. I tried many other treatments including different medications, physical therapy, massage therapy, acupuncture, antibiotics, a special diet and some alternative therapies. Sometimes when I tried a new treatment, I would get 30-70% better, but it only lasted for about 8 weeks and then I was right back where I had been. After acupuncture on my back, I developed lower back pain that soon became intense and constant. A diagnosis of fibromyalgia was finally made, but even the specialist at a major university medical center offered little encouragement, only telling me to take my medication and try to be as active as possible. It was very depressing to say the least.

My last two years of high school, I was rarely able to attend classes. Most of the time it was too painful to drive, to sit in class, to go up and down stairs, and to take notes. I did my work primarily from home, but it had to be limited because I had so much pain in my arms when I tried to write, and because I was always so tired. I missed all the school activities I had been looking forward to, including a much anticipated school trip to Europe. I did graduate with high grades, but not with the honours and scholarships I had hoped for. I lost all my friends except one, and had no social life. The only things I could do for 'fun' were watch movies at home or read.

By the time I graduated from high school two years later, I had adjusted to my symptoms to some extent, and was determined to go to college. I had to let go of my dream to go to the university my mom had attended; instead I attended a smaller university closer to my home. The first semester was very difficult, and I had to drop a class in order to keep up in the other classes. I made it through my first year with high grades, but I had no friends because I couldn't socialize due to constant pain and fatigue.

Last fall I started my second year in college, and soon my mom started telling me about this idea she had found about chronic pain being caused by underlying emotions. I thought that it might apply to other people, but not to me --- my pain was real and not 'in my mind'. She really wanted me to do some writing on past emotional issues, but I thought it was a bit crazy. I was also afraid of a getting my hopes up, getting better and then getting worse again as I had in the past. Finally a few weeks later, we discussed it again and she suggested that I consider just trying Dr Schubiner's course over my holiday break.

I had been thinking about it some more, and had decided that maybe I should give it a try. One of the major reasons I reconsidered the idea was that my mom had reminded me that when I was about 10 years old, I had suffered from abdominal pain for about a year. It gradually became so severe that I missed a lot of school (and I was a kid who absolutely loved school!). After many tests, the doctors at a major university medical center did not know what was wrong, so my parents took me out of state to another specialist. This specialist said that I had an oversensitive nervous system in my gut, misinterpreting normal sensations as pain. He prescribed an antidepressant that helps with pain and strongly advised my parents to take me to a counsellor. After a month on the medication, my pain was pretty much gone.

The doctor didn't explain why I should have counselling, so we never pursued it. Now it made sense - he knew about MBS and knew that I needed to address my underlying emotional issues. It seemed possible that it was all MBS, and that my abdominal pain had changed to other symptoms such as headaches, itchy eyes, lower back pain and knee pain, and finally severe widespread pain at age 16.

Over my holiday break I worked on Dr Schubiner's program. I watched most of the videos and started writing. After I had written on emotional issues about six times, I started getting worse. I was more painful and some of my old symptoms returned, like the hot and cold flashes and cold feet. I saw Dr Schubiner and he told me that I was on the right track, to just maybe take things a little more slowly. I wrote about ten times before going back to school in January, then I wrote a few times a week. Once I started writing, I realized that I had kept a lot of my emotions inside. We had been dealing with a number of health and other stressful issues in our family for many years. I didn't want to make things harder for my family, so I tried to be a 'good girl' and never complained, got angry or showed that I was sad or upset. I kept everything inside.

For three years I had used an ice pack on my back every single day to numb the pain, and after working on the program for about six weeks, I didn't need the ice anymore because my back no longer hurt. My energy level started to increase, and my arm and leg pains became much milder.

My life has completely changed. In the past four months since I started the program, I have joined a university service group. Each week I work a number of hours at a community event, something I never could have done before without terrible pain during or afterwards. It is a lot of fun and I am finally making new friends. I also have a serious boyfriend now, and it is so great to spend time with him, his friends and his family like a 'normal' person. I am hoping to get a summer job babysitting. I am confident that next year I'll be able to handle a more normal course load in college, and I am planning on going to graduate school in some area of health care.

Sometimes I still get pain in my arm or leg, or a bad headache, but I know it's because I haven't written in awhile. Once I start writing again, I feel better. After nearly four years of constant pain and fatigue, I finally have my life back which I credit to Dr Schubiner's method.


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About Dr Howard Schubiner

Dr Howard Schubiner MD is board certified in paediatrics, adolescent medicine, and internal medicine and is the director of the Mind Body Medicine Center at Providence Hospital in Southfield, MI. He is a Clinical Professor at Wayne State University School of Medicine and is a fellow in the American College of Physicians, the American Academy of Pediatrics, and the Society for Adolescent Health and Medicine. He has authored more than sixty publications in scientific journals and books and has given more than 250 lectures to scientific audiences regionally, nationally, and internationally.

Dr Schubiner has consulted for the American Medical Association, the National Institute on Drug Abuse, and the National Institute on Mental Health. He is also a senior teacher of mindfulness meditation. He has been included on the list of the Best Doctors in America since 2003. Dr Schubiner lives in the Detroit area with his wife of twenty-six years and has two adult children. He may be contacted on Tel: 001 248-849-4728;

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